Behavioral therapists based at schools

Elementary schools have always had one-on-one supports for the kids. Special reading teachers, gifted program mentors, perhaps a school nurse.

Now, as a continued slow economy stresses some families, a couple of school districts in the Kansas City area have added one more — on-site behavioral therapists.

The therapy programs in Belton and Lee’s Summit schools aren’t the result of expansion of the schools’ regular budgets. They are possible because of grants from the non-profit Health Care Foundation of Greater Kansas City and partnerships with health care professionals and community advocates.

And so far, they are extremely popular with parents, teachers and counselors alike.

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“When I announce that we’ve gotten a grant for another year, the response from teachers has just been tremendous,” said Heather McFarland, executive director of the Belton Educational Foundation. Parents, too, like that their child gets to be seen in a familiar atmosphere and doesn’t have to miss hours of school to attend therapy sessions, she said.

Let’s be clear. The therapy sessions are worlds away from the stereotypical guidance counselor appointments about course credits and careers. This is therapy for depression, post-traumatic stress, anxiety disorders and a host of other mental health issues that experts say are best caught early.

Belton gets a $243,000 grant to pay for four therapists to see students and in January, $33,000 will be added for a part-time therapist for pre-kindergarten. The district collaborates with Pathways Community Behavioral Health Center, of Raymore, which provides the service.

Lee’s Summit is in its second year of a similar grant. This year the school will get $40,000 for a therapist from Truman Medical Center’s Lakewood Counseling Service to come to Lee’s Summit, Meadow Lane and Westview elementary schools.

In both school districts, the grant money comes through the Health Care Foundation of Greater Kansas City.

In-school therapy is becoming a sought-after service for schools because of the confluence of several trends, McFarland said. The recession, followed by slow economic growth, has made it harder for parents in struggling families to get time off from work to take kids to regular therapy, she said, even if they can afford it.

School budgets are generally too tight to provide this level of care with taxpayer money. But at the same time, experts are beginning to recognize the mental health needs of children and to stress the importance of working with them early.

The need takes on even more importance in small towns, where access to a therapist may be limited, McFarland said.

Having mental health providers come to the schools has definitely been a trend in the past decade, said Mary Kettlewell, program officer of the Health Care Foundation.

“There was a period when we had the luxury of having social workers in schools,” she said. “When the economy was better, it was easier for parents to transport their kids to therapy.”

That changed when the economy tanked and safety nets shrank, she said.

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Meanwhile, mental health professionals are putting more of an emphasis on identifying behavioral problems and working with them at an earlier age, she said.

Susan Guental, who oversees the Lee’s Summit grant program, cited research from a 2013 study by the National Alliance on Mental Illness that shows 13 percent of kids 8 to 15 years old have some type of mental illness but only 20 percent of them receive the services they need.

It’s hard to know whether there are more behavioral problems now or whether the increased number comes from better identification, said Guental, a former counselor. In the past, she said, those kids might have continued to have problems until they eventually dropped out of school.

At the same time, parents may be more open to intervention, said Andres Dominguez, program officer at the Health Care Foundation.

“Society overall is being a little more open about mental illness,” he said. “School districts realize the problem is beyond their capacity. They can’t do it alone, so they come to us.”

Better access to therapy can help teachers, parents and kids work together to modify behaviors, she said.

In-school therapy sessions are effective because they make it easy to include teachers in the learning strategies, according to everyone involved with the local programs. If a child and therapist work on how to deal with anger, for example, the teacher can be included in the mix. The therapist and teachers can then work as a team.

“That’s the beauty of school-based therapy,” said McFarland. “School is where they spend the majority of their waking hours.”

Having everyone working together, she said, creates a “culture of improvement.” And it empowers teachers who have wanted to help these students but do not have the skills to deal with mental health problems.

Parents are generally relieved and grateful for the help, said Guental. “The parents really want their child to get help, but maybe couldn’t access it before,” she said.

Because grant money is finite, school districts focus on schools with parents who face the most challenges getting therapeutic care. Both Lee’s Summit and Belton zero in on schools with high percentages of children who qualify for free or reduced-price school lunches. More than half the children at Lee’s Summit Elementary fit that bill.

Belton schools have a similar number, McFarland said. But that district also had another reason to be interested in therapy services. Seventy-five kids a year out of the district’s 5,000 were in in-patient psychiatric care before the program began four or five years ago, she said.

Since the program started, she said, that number has been cut by more than half.

Belton has four therapists full time at its schools. In addition, they offer the therapy sessions through summer school.

So far the area school districts using the grants have tended to be a little more rural, said Kettlewell. In larger districts, like the Kansas City Public Schools, the size and scope of the problem and the large number of schools make the grants more difficult to come up with, she said.

So far, schools in the Northland haven’t availed themselves of the grants, said JoAnn Werner, associate director of Tri-County Mental Health Services.

Students there often get help through referrals or in-home visits by Tri-County staff, said Jamie Wehmeyer, director of assessment and youth services.

Tri-County case managers see students and their parents at home, usually during non-working hours.

“The staff is very amenable to parents’ schedules,” Wehmeyer said. “They don’t work a 9-5 schedule at all.”

Home appointments allow parents to get advice on how to help their children deal with mental issues, she said. As with the in-school programs, the staff also meets with the school staff so everyone can be on the same page.

Demand and requests from school districts have been steady in the Northland, Wehmeyer said.

“We’re always busy,” she said.

Tri-County joins other mental health agencies in the area in trying to improve training for early intervention, she said.

“The earlier we get in there, the more of a difference we can make.”

Another impetus, Wehmeyer said, is that more people “are recognizing the impact trauma has at a young age.”

The increased need and positive reviews of programs like those in Belton and Lee’s Summit have made the grants some of the most sought-after the Health Care Foundation gives. The non-profit has a $4.25 million budget for mental health services each year, and that’s not all for school-based programs, “though it easily could be,” said Kettlewell.

“This year we got almost $13 million in requests for that $4.25 million,” she said. “We’re one of the few funders,” she added. “We’d love to be able to fund every school. It’s a dilemma.”

Kettlewell and Dominquez both said granting agencies can’t do it alone. The states and federal government need more effective public policy, they said.